Domenic Michael Canonico, MD is a medicare enrolled "Otolaryngology - Plastic Surgery Within The Head & Neck" physician in Tullahoma, Tennessee. He went to Vanderbilt University School Of Medicine and graduated in 1987 and has 37 years of diverse experience with area of expertise as Otolaryngology. His current practice location is
507 Nw Atlantic St, Tullahoma, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 393-4332.
Domenic Michael Canonico is licensed to practice in Tennessee (license number 18819) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1770551640.
Physician's Profile
| Full Name | Domenic Michael Canonico |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Experience | 37 Years |
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| Location | 507 Nw Atlantic St, Tullahoma, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Domenic Michael Canonico attended and graduated from Vanderbilt University School Of Medicine in 1987
NPI Data:
- NPI Number: 1770551640
- Provider Enumeration Date: 03/08/2006
- Last Update Date: 07/14/2015
Medicare PECOS Information:
- PECOS PAC ID: 9537178587
- Enrollment ID: I20080828000139
Medical Identifiers
Medical identifiers for Domenic Michael Canonico such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1770551640 | NPI | - | NPPES |
| 0192943 | Other | TN | BCBS |
| 040013804 | Other | TN | RAILROAD MEDICARE |
| 3085592 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 18819 (Tennessee) | Primary |
Medical Facilities Affiliation
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Domenic Michael Canonico is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Domenic Michael Canonico, MD
507 Nw Atlantic St,
Tullahoma, TN 37388-3504
Ph: (931) 393-4332 | Domenic Michael Canonico, MD
507 Nw Atlantic St,
Tullahoma, TN 37388-3504
Ph: (931) 393-4332 |
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